GAO Report Critical of Care for Indians

Associated Press

Published 4:00 am, Saturday, April 29, 1995

1995-04-29 04:00:00 PDT Washington -- The Indian Health Service screens its temporary doctors so poorly that it has unknowingly hired physicians with histories of malpractice and other misconduct, congressional investigators say.

The health service, which provides free care to more than 1 million American Indians, many on remote reservations, relies heavily on temporary physicians because it is chronically short of medical personnel.

The doctors are hired through private companies that usually are not required to reveal all the information they have on the physicians, according to a report by the General Accounting Office, the investigative arm of Congress.

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The health service often does not independently check the doctors' credentials, and Indian Health Service hospitals that do discover problem doctors often do not share their findings with other hospitals, the report said.

The investigators said the health service should establish a system for exchanging information about doctors and require its physician suppliers to inform the agency about the status of all the doctors they provide.

Except for emergencies, the health service should not hire doctors without a complete examination of their medical licenses, the GAO said.

"American Indian and Alaskan native patients should have reasonable assurance that every physician who treats them in an IHS facility is qualified to do so," the GAO reported.

The Public Health Service, which oversees the Indian Health Service, said it agrees with the GAO's recommendations.

An Indian Health Service spokesman had no immediate comment yesterday. Representative Tim Johnson, D-S.D., said that although there have been some problems with temporary doctors, most of the physicians hired by the health service "have been excellent."

"It is likely, given the budget constraints that we face, that the utilization of temporary physicians will be an ongoing reality."

The Indian Health Service, which had a $1.9 billion budget last year, serves 49 hospitals run by the agency or individual tribes and operates 465 clinics. During one nine- month period in 1993, the agency spent more than $16 million on temporary physicians, the report said.

The GAO investigation focused on hospitals in Ada and Claremore, Okla., but a GAO official said yesterday that other Indian Health Service facilities followed similar practices in hiring temporary doctors.

Indian Health Service facilities, the GAO said, cannot meet all the medical needs of Indians. The agency buys some services from outside hospitals and doctors but has only enough money for 75 percent of the need, the agency said.

During the 1993 budget year, the agency denied or deferred nearly 71,000 requests for outside medical services, including preventive care and treatment for chronic conditions, the GAO said.